Why do you get them? What can you do about them?
Bunions form due to a process called adaptation.
An adaptation is a change that occurs over time as a response to a biological signal. In this case, it is the signal to create more robustness in a site that is under stress. The Bunion is the correct response to a biological signal to add robustness to a site that is under continual stress/overload. Bunions can occur at the first (big toe) metatarsal joint and also the fifth (baby) toe metatarsal head, often referred to as a “bunionette” (which sounds a lot cuter than it is).
Hallux valgus (or hallux abductovalgus) is the anatomical term for the deformity which displaces the bones of the big toe and the first metatarsal. The associated soft tissues (tendons, ligaments and muscles) of this joint are displaced and experience loads that are unnatural both in intensity and in plane, or position.
Walking a certain way, or changing the optimal mechanics of a natural (bare) foot, is going to create changes to the loads to your foot, which your body will deal with by possibly increasing bone density or shape in response to an unnatural load to tissues that would otherwise fail. The softer tissues of the muscles and ligaments will become misaligned and can cause inappropriate wear on structures of the foot, often resulting in pain.
You might think that bunions are genetic. Genetics are misunderstood as a kind of code written into your DNA that is inevitable – meaning you can’t do anything about it and you are simply doomed to the outcome. It seems reasonable to assume that bunions are genetic because you might have very similarly shaped feet to one of your parents. You do inherit some things from your parents: the size, girth and shape of the bones. However, bone is living tissue. It can morph and change depending on the loads it is subject to most frequently. You may have inherited the shape of the pelvis, hips, legs and feet bones from your parents, but it’s how you use them that determines their final shape and function. Another thing that has perhaps a greater influence on the shaping of your bones is the movement “accent” that you learn from your parents. Just as we pick up speech patterns as we learn to talk, we pick up movement cues from watching those around us as we develop our motor skills. It is these movement accents that we mimic and which become our habitual way of walking that eventually creates the bunion. So it’s important that we look at the mechanics of how we walk and their contribution to our shape, more so than the genetically inherited shape of our bones. Bunions are not something written into the DNA code that will simply manifest one day without cause – they are mechanically stimulated. If bunions were genetic, you’d think they would occur on both sides to the same extent, but that is rarely the case. Many people have only one (and that’s a big clue to how you are using your body asymmetrically) and others have a bigger one on one foot than the other.
There are other reasons we walk the way we do, that are not genetic or learned. We can be literally shaped by our environment. Shoes, chairs, our urban habit of making everything flat and level, all leave us with adaptations in the length of our muscles and shape of our bones, which in turn affects the way we stand and walk.
You have the potential to develop a bunion if you are creating the environment that causes it. Your body is actually responding appropriately. It’s not a positive adaptation, but it’s a correct one. What an amazing thing our bodies are, yet we continually denounce them for betraying us.
My movement solutions to bunions can be found in my online workshop Healthy Moving for Bunions. (This link will take you off site to another site, which hosts this course.)
Certified Restorative Exercise Specialists should contact me for a RES-only link. This course is worth 2 CEUs.